Angiographic, operative, and histologic findings after embolization of craniofacial angiomas

After pre- or intraoperative angiography and Gelfoam embolization in patients with deforming vascular malformations in the craniofacial region, the angiographic findings and the results of embolization were controlled by operation and histology. In arteriovenous hemangiomas the disfigurations of the craniofacial region originate from the shunt vessels themselves, in capillary hemangiomas exclusively from neoplastic, pathologically dilated and convoluted veins which could be demonstrated only by percutaneous punctures. Lymphatic hemangiomas also could be radiologically shown only after direct punctures and without any feeding or draining vessels. During operation vast necrosis of the fatty tissue in the region of embolization and massive phlebolithiasis in the draining veins were found. Histologically, arterial obliterations could be shown in the former shunt area. The reconstructive operations could be done in bloodless surgical regions and always showed good cosmetic results, which were regarded as constant because of the embolization of the shunt area.